Headlines

The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care, according to a new analysis by the influential RAND Corporation.

Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place.

“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,” said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal.

RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, that have profited by developing and selling electronic records systems to hospitals and physician practices. Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005.

Hmmm… do you think the results of the initial study were in anyway influenced by the funding sources?
Naaaaaaaaaah.

You forgot the taxes that need to be implemented as well. A “EMRS” tax to raise awareness of electronic medical records systems.
Also, the rich need to pay their fair share, because money.
I don’t spend too much, the, REPUBLICANS did it. (DUM DUM DUMMMMM).

My wife has spent the last 20 years working in the development of electronic medical record systems. They do work and can cut costs and improve service; but they don’t for one simple reason. They are not used well.

If you go to an ER today someone will sit down with a clipboard and paper form and take a medical history from you. A few hours later a Doctor will come in and ask you most of the same questions again and write nothing down, but also does not have access to the medical history that was taken on arrival. Then if you are admitted you will encounter another nurse who will again ask you all those same questions, because the first one is not available in any system yet and the one the Doctor took was not recorded at all.

I encountered all this multiple times with my own parents, one of which had a serious allergy to one specific type of anti-biotic. She was also prone to UTI’s and everytime she entered the hospital for any reason and had a UTI they tried to give her the one med she could not take, even though several times I personally told multiple medical history takers about it. At least twice I stopped them from putting that med in her IV at the last moment. They had no idea what was in her record because they simply did not look at it. A nurse wold ask Mom if she was allergic to anything, but as she was also suffering from dementia she would say “no” most of the time. One day I asked a nurse who was asking her questions if medical care decisions would be made based on Mom’s answers to those medical history questions and she said that, yes of course they would. I said, watch this. I then asked Mom how old she was that day and she said she was 26 or 27, but was not sure which. She was 82. The nurse got angry with me and stormed out of the room.

Another very good point. If this technology is so great, why isn’t everything being taken down via iPads?
Then have these iPads wirelessly downloading this info to the various people attending that patient?
In theory, all of these things would be so great.
But we all know how technology works in the real world.
It is often rarely that wonderful & is usually accompanied by flaws that delay things so much it would be easier to do this stuff the ‘old fashioned’ way.
But I doubt even if this stuff worked perfectly, that people would still bother to read the info when making decisions.

Another problem has been that over the years different hospitals have invested tens of millions of dollars each, into systems that are overly complex and not compatible with those of other hospitals. I think any first year computer science student could probably build a better system with Microsoft Access, for pennies on the dollar.

Still another problem is that a great deal of the information in a medical record must come from the Doctor, and a huge number of Doctors are nearly computer illiterate or just to self-important to take the time to put the information in right.

Gee, as a physician in private practice struggling to keep every employee I’ve had for over ten years now without a turnover just what I wanted to do was fork over 20,000 for computerized records. I’m so glad I’m closer to the end of my career than at the beginning. I guess what’s so frustrating is that sales people take their product and quadruple (at least) the price they might sell it to a plumbing outfit, if it is “medical” and mama governement is threatening to “mandate” it.

I see several problems with EMRs. Garbage in, garbage out — it will increase the amount of bad information. If you tell a nurse or doctor garbage, they have common sense to filter it out. Not so a computer. At some point, doesn’t a doctor need to understand a patient in his own way? Isn’t that why we pay them? Also, have you ever seen the medical records a doctor keeps on his patient? Often they’re nearly indecipherable to those other than the doctor. Isn’t there a line between public medical data, and a doctor’s unique individual understanding of a patient? Isn’t there a grey area where the patient doesn’t know what’s wrong with him, and neither does the doctor, and they’re on a journey of diagnoses and/or treatment? How are electronic medical records supposed to capture that? Also, do you want all your communications with your doctor codified so they can be made public? How about mental health records? How about transcripts of therapy sessions?